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Clinical and Laboratory Profile of Patients With Type 2 Diabetes With Low Glomerular Filtration Rate and Normoalbuminuria

Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

Address correspondence and reprint requests to Luís Henrique Canani, Servio de Endocrinologia do Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Prédio 12 4 andar, 90035-003, Porto Alegre-RS, Brazil. E-mail: luiscanani@yahoo.com.br

Abbreviations: eGFR, estimated glomerular filtration rate • GFR, glomerular filtration rate • HOMA-IR, homeostasis model assessment of insulin resistance • UAE, urinary albumin excretion

The first 20% of the full text of this article appears below.

	INTRODUCTION

 
The initial evidence of diabetic nephropathy in type 2 diabetic patients is the development of microalbuminuria (1). However, the UK Prospective Diabetes Study demonstrated that 51% of patients who progress to chronic renal failure had no preceding albuminuria (1).

Patients with low estimated glomerular filtration rate (eGFR) (<60 ml/min per 1.73 m²) and normoalbuminuria presented an increased rate of cardiovascular disease (2–4) due to unknown reasons. Aggregation of conventional cardiovascular risk factors might play a role. Therefore, the aim of this study was to analyze the clinical and laboratory features of type 2 diabetic patients with low eGFR and normoalbuminuria.

	RESEARCH DESIGN AND METHODS—

 
A cross-sectional study was performed in all consecutive normoalbuminuric type 2 diabetic patients attending the outpatient clinic at Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil, between 1999 and 2006 with eGFR >15 ml/min per 1.73 m². Normoalbuminuria was defined by urinary albumin excretion (UAE) values <20 µg/min, <17 mg/l (random sample), or <30 mg in 24 h (5) on at least two occasions over the preceding 6 months while on their usual antihypertensive medication. eGFR was calculated using the Modification of Diet in Renal Disease formula: 186 x [plasma creatinine (mg/dl)^–1.154 x age (years)^–0.203 x (1.212 if black) x (0.742 if female)] (6). All patients answered a standard questionnaire and underwent physical examination and laboratory tests. Metabolic syndrome was defined according . . . [Full Text of this Article]

	RESULTS—

 

	CONCLUSIONS—

 

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